mrcem2-1446

A 7 year old male is brought into the emergency department by concerned parents. The child has been feeling unwell for the past 2-3 days, complaining of stomach pain and feeling nauseous. The parents have also noticed that the child has been drinking more than usual and constantly feels thirsty. Tests confirm a diagnosis of diabetic ketoacidosis (DKA) and appropriate treatment is initiated. About 4 hours after starting treatment, one of the nursing staff asks you to assess the patient as he has been experiencing headaches and has started vomiting. The following repeat observations are recorded:

Pulse: 58 bpm
Respiration rate: 28 bpm
Temperature: 37.2ºC

What is the most appropriate course of action?